Surgical instrument for hysterectomy

ABSTRACT

A surgical instrument for hysterectomy, which includes a Cshaped body, the cantilevered sections thereof forming a gap open on one side to accommodate the uterine portion being excised, a locking bar adapted to interact with the ends of the cantilevered body sections, and a knife. The knife is free to move along the guide slots of the body and the locking bar in the direction from one of the cantilevered body sections to the other, one of said cantilevered body sections serving as a support for the knife during cutting. The knife has the shape of a hollow right truncated trihedral prism, wherein the edges of the faces that overlook the knife-supporting body section are cutting edges adapted to interact with the correspondingly-shaped faces of said supporting section. One of the knife faces is lanceolate in shape when viewed from above, its pointed end being advanced with respect to the cutting edges of other two knife faces.

United States Patent 1 Smirnov et al.

1541 SURGICAL INSTRUMENT FOR HYSTERECTOMY [73] Assignee: Vseojuzny Nauchno-lssiedovatelsky lnstitut Khlrurglcheskoi Appratury l Instrumentov, Moscow, U.S.S.R.

221 Filed: May4, 1971 21 Appl.No.: 140,204

[30] Foreign Application Priority Data May 4, 1970 U.S.S.R. ..1431407 [52] US. Cl. ..128/305, 30/124, 30/241 [51] Int. Cl ..A6lb 17/32, B25f 3/00, B26b 13/00 [58] Field of Search ..30/l24, 130, 182, 241; 128/305, 318

[56 References Cited UNITED STATES PATENTS 8/1940 Stadle ..128/305 11/1972 Elstein ..128/305 6/1971 Jascalevich ..128/305 X [451 Jan. 2, 1973' 2,236,833 4/1941 Pellet al ..30l182 UX FOREIGN PATENTS OR APPLICATIONS 1,239,942 7/1960 France ..30/241 Primary Examiner-Channing L. Pace Attorney-Holman & Stern [57] ABSTRACT A surgical instrument for hysterectomy, which includes a C-shaped body, the cantilevered sections thereof forming a gap open on one side to accommodate the uterine portion being excised, a locking bar adapted to interact with the ends of the cantilevered body sections, and a knife. The knife is free to move along the guide slots of the body and the locking bar in the direction from one of the cantilevered body sections to the other, one of said cantilevered body sections serving as a support for the knife during cutting. The knife has the shape of a hollow right truncated trihedral prism, wherein the edges of the faces that overlook the knife-supporting body section are cutting edges adapted to interact with the correspondingly-shaped faces of said supporting section. One of the knife faces is lanceolate in shape when viewed from above, its pointed end being advanced with respect to the cutting edges of other two knife faces.

2 Claims, 8 Drawing Figures i i- W PATENTEDJAN 2 m 3 707.970

SHEET 1 [IF 2 uni-0..

PATENTEDJAN 2 1975 3 I 7 07 9 7 0 sum 2 0r 2 1 SURGICAL INSTRUMENT FOR IIYSTERECTOMY The present invention relates to surgical instruments and has particular reference to instruments for' hysterectomy or extirpation of the uterus made use of in gynecological practice.

Known in the present state of gynecological surgery is the use of scalpels or surgical knives for the excision of the uterus.

In supravaginal hysterectomy the uterine body is released from its ligaments, blood vessels are ligated, whereupon the uterine body is caught and retracted by the forceps and the portion of the uterus to be extirpated is severed by a scalpel. A V-shaped cavity should then be incised in the uterine stump so that its depth and width as well as the thickness of the walls thereof will ensure unobstructed suturing of the stump lips and obviate eruption of ligature sutures, thus providing the most rapid healing of the uterine stump as well as an uneventful and favorable course of the postoperative period.

However, the use of scalpel or operative knife for performing hysterectomy and establishing a V-shaped cavity in the amputational stump thereof is far from convenient since pathologically changed uterine tissue has an exaggerated density and is therefore hardly amenable to being cut.

As a result the surface of a uterine stump is rough and uneven since the extirpation of the uterus is not performed instantaneously and in the depth of the operative area.

Inadequate width arid depth of the V-shaped cavity results in a failure to join the lips of the uterine stump upon application of sutures, the stump becomes erupted and bleeding occurs with the result that a repeated surgical intervention must be carried out to enlarge the V-shaped cavity both as to the width and depth thereof. 1

All this makes the operative procedure more prolonged and imposes complications upon the postoperative process of healing of the uterine stump.

It is therefore the main object of the present invention to provide a surgical instrument'for hysterectomy that will have a simple design, ensure a convenient approach to the extirpated portion of the uterus, and make it possible to reduce the time spent for the operative procedure by virtue of concurrent extirpation of the uterus and the establishing of an equilateral V- shaped cavity in the stump thereof to exclude any possibility of inflicting injury upon the adjacent tissues.

The above object is accomplished by providing a surgical instrument for hysterectomy, according to the invention which includes a C-shaped body whose cantilevered sections form a gap open on one side to accommodate the uterus portion to be excised a locking bar adapted to interact with the ends of the cantilevered body sections and a knife provided with an actuator to impart reciprocating motion thereto along the guide slots of the body and of the locking bar in a direction from one of the cantilevered body sections to the other, one of said cantilevered body sections serving as a support for the knife during cutting. The knife is shaped as a hollow right truncated trihedral prism with the face edges that overlook the knife-supporting body section being cutting edges and interacting with the correspondingly shaped faces of said knife-supporting body section. One of the knife faces is lanceolate in shape when viewed from above, its pointed end being advanced with respect to the cutting edges of the other two knife faces.

Such an instrument is simple in design and provides a convenient approach to the portion of the uterus to be excised during supravaginal hysterectomy. In addition, the instrument allows fixing of the uterine body during operation, cuts down operational time by virtue of the concurrent extirpation of the uterus and formation of an equilateral V-shaped cavity in the stump thereof, and ensures guided knife movement while reducing cutting force.

It is preferred that the lateral cantilevered sections of a the C-shaped body be provided with cavities to accommodate the knife in its extreme positions, thereby excluding any possibility of injuring the adjacent tissues when approaching and applying the instrument to the portion of the uterus to be excised or withdrawing the instrument from the operative area upon extirpation of the uterus.

The nature of the invention is further explained in the following disclosure of its exemplary embodiments given by way of illustration to be taken in conjunction with the accompanyingdrawings, wherein:

FIG. 1 illustrates a surgical instrument for hysterectomy according to the invention, in an elevational view, partly in cross-section;

FIG. 2 is partly sectional plan view of a surgical instrument for hysterectomy, according to the invention;

FIG. 3 is a section taken along the line III--III in FIG.

FIG. 4 illustrates the application technique of a surgical instrument according to the invention, in supravaginal hysterectomy;

FIG. 5 illustrates the uterus while fixed in a surgical instrument by means of the locking bar, according to the invention;

FIG. 6 illustrates the uterus extirpation procedure with the use of a surgical instrument, according to the invention;

FIG. 7 illustrates the excised uterus and the V- shaped cavity in the uterine stump resulting from the operation of hysterectomy by using a surgical instrument, according to the invention; and

FIG. 8 illustrates the technique of suture application to the uterine stump.

Now referring to the Figures, the surgical instrument for hysterectomy includes two major structural components, viz., a knife 1 (FIGS. 1, 2) and a C-shaped body 2.

The knife 1 is shaped as a hollow night truncated trihedral prism whose face 3 is lanceolate in shape if viewed from above, whereas its pointed end is advanced with respect to the cutting edges of two other knife faces 4 (FIG. 3).

The knife 1 is connected through a pusher 5 (FIG. 1) to the actuator formed as a screw 6 interacting with a nut 7. The screw 6 is located in a cantilevered section 8 (FIG. 2) of the body 2 and by means of the nut 7 causes the knife 1 to displace from one cantilevered section 8 of the body 2 to another such section 9, the cantilevered section 9 of the body 2 serving as a support for the knife during cutting and having faces 9' corresponding in shape to faces 3 and 4 of the knife 1 and adapted to interact therewith during cutting.

The knife 1 has projections (FIG. 3) with which it can travel along a guide slot 11 of the body 2 and a guide slot 12 of a locking bar 13.

When in the initial position the knife 1 (FIG. 1) occupies a cavity a provided in the cantilevered section 8 of the body 2 so that the cutting edges of its faces 3 and 4 are completely buried in the cavity a which precludes any injury to the adjacent tissues when approaching and applying the instrument to. the uterine portion to be excised.

When in its terminal position the knife 1 occupies a cavity b provided in the section 9 of the body 2 so that the cutting edges of the knife faces 3 and 4 are likewise completely buried in the cavity b which prevent any injury to the adjacent tissues when withdrawing the instrument from the operative area upon extirpation of the uterus.

The locking bar 13 (FIG. 2) is located in the section 8 of the body 2 so as to freely engage the opening in the section 9 of the body 2. When in its extreme positions the locking bar 13 is fixed in place by means of a spring-loaded retainer 14.

The surgical instrument for hysterectomy operates as follows:

Uterus 16 to be excised having been liberated from its ligaments, with its blood vessels properly ligated, exposed and brought to the operative zone by means of uterine grasping forceps (FIG. 4), the surgical instrument of the invention is brought adjacent thereto with the open-end gap d of the body 2, the knife 1 occupying the cavity aof the body 2. Then the locking bar 13 (FIG. 5) is moved along the cantilevered section 8 of the body 2 towards the cantilevered section 9 and fixed in its terminal position with the springloaded retainer 14 (FIG. 2), with the result that the uterus to be excised becomes fixed in position in the gap d (FIG..5) of the body 2. By rotating the nut 7 (FIG. 1.) interacting with the screw 6, the knife 1 is caused to move along the guide slots 11 and 12 (FIG. 3) of the body 2 and the locking bar 13, respectively, towards the cantilevered section 9 (FIG. 1) of the body 2, said section serving as a support for the knife 1 during cutting. While moving the knife 1 performs extirpation of the uterus 16 (FIG. 6) with its lanceolate face 3 and establishes an equilateral V-shaped cavity (FIG. 7) in a stump 17 of the uterus with its two other faces 4 (FIG. 6).

Next the surgical instrument for hysterectomy is withdrawn from the operative field, its knife 1 having been buried beforehand in the cavity b (FIG. 1).

Then to the thus-formed lips of the stump 17 of the uterus 16 having the V-shaped cavity f," sutures are applied as shown in FIG. 8, the lips of the V-shaped excised during supravaginal hysterectomy, this being due to the provision of the gap d open on one side in the body 2 of the instrument.

The instrument effects fixing of the uterus being 0 erate upon by 'ine ns of the lock'n ar 13 which 0 verst e pen side 0 the gap d, t e e yrestrlctmg the radial displacement of the uterus being extirpated, and reduces the operational time by combining the process of hysterectomy with I the simultaneous establishing of an equilateral V-shaped cavity in the stump thereof.

The instrument ensures'a guided movement of the knife 1. The cutting force necessary for the uterus to be excised with the use of the herein-proposed instrument.

is rather small due to special shape of the knife described hereinabove. This makes it possible to obtain an even surface of the uterine stump and ensures its rapid healing within the post operative period.

What we claim is:

1. A surgical instrument for hysterectomy comprising: a C-shaped body having cantilevered sections which form a gap open on one side to accommodate an excised portion of a uterus; a locking bar extending between the ends of said cantilevered sections of the body to close said gap; a guide slot in said body; a guide slot in said locking bar; a knife located in and capable of free displacement along said guide slots of the body and of the locking bar from one of said cantilevered body sections toward the other, one of said cantilevered body sections serving as a support for said knife during cutting, said knife being shaped as a hollow right truncated trihedral prism, the edges of the faces thereof that oppose said supporting body section being cutting edges, the faces of said supporting body section corresponding by the shape to said cutting edges of the knife and serving to interact therewith during cutting, one of said knife edges being lanceolate in shape, and being advanced with respect to the cutting edges of the other two said faces; and an actuator for said knife.

2. A surgical instrument as claimed in claim 1, wherein provision is made for interior cavities located in said cantilevered sections of the C-shaped body, said cavities serving to accommodate said knife in its extreme positions.

a: a: k s a: 

1. A surgical instrument for hysterectomy comprising: a C-shaped body having cantilevered sections which form a gap open on one side to accommodate an excised portion of a uterus; a locking bar extending between the ends of said cantilevered sections of the body to close said gap; a guide slot in said body; a guide slot in said locking bar; a knife located in and capable of free displacement along said guide slots of the body and of the locking bar from one of said cantilevered body sections toward the other, one of said cantilevered body sections serving as a support for said knife during cutting, said knife being shaped as a hollow right truncated trihedral prism, the edges of the faces thereof that oppose said supporting body section being cutting edges, the faces of said supporting body section corresponding by the shape to said cutting edges of the knife and serving to interact therewith during cutting, one of said knife edges being lanceolate in shape, and being advanced with respect to the cutting edges of the other two said faces; and an actuator for said knife.
 2. A surgical instrument as claimed in claim 1, wherein provision is made for interior cavities located in said cantilevered sections of the C-shaped body, said cavities serving to accommodate said knife in its extreme positions. 